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Obesity and Sexual Health

A global public health concern
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Obesity has become a common global public health concern that affects both children and adults for the past few decades.

The incidence of obesity is also on the rise in Singapore. According to the National Population Health Survey 2021/2022, obesity affects 13.1% of males and 10.2% of females [1]. The causes of excessive weight gain tend to be multifactorial, a combination of genetic predisposition, physical activity levels, sleeping patterns, and eating habits. 

In this article, we explore the effect of obesity on sexual health and discuss medical options that can be offered to address this rising concern.

obesity increasing
Obesity is on the rise in Singapore and around the world.

Implication of Obesity in Sexual Function 

Research has shown that the physiological state of an obese person can impact a person’s sexual function [2].


In obese women, a normal menstrual-ovulation cycle can be affected due to a persistent hyperandrogenic state – a body physiological state where one has excessive male hormones [3]. The level of sex-hormone binding globulin (SHBG) is lesser, while male hormones, such as testosterone, dihydrotestosterone, and androstenediol, can be much higher. Obesity is also associated with clinical symptoms such as menstrual abnormalities, reduced libido, and urinary incontinence in females as an effect of hormonal dysregulation.


Ironically, in men, obesity is associated with reduced testosterone due to the aromatisation of excessive fat (adipose) tissues into estradiol (a type of female hormone) [4]. The tilt of hormonal equilibrium causes men with obesity to have reduced libido and erectile dysfunction. 

Both females and males

As the body of a person with obesity is always in a ‘physiological inflammatory state’, the oxidative stress can impair both sperm and ovum qualities [5], leading further to infertility issues [6].

A person with obesity has a higher risk of cardiovascular chronic disease [7], including diabetes [8]. 

In poorly controlled diabetes, blood vessels and nerve endings can be affected, leading to poor circulation of the genital region. This can present itself with sexual dysfunction symptoms such as physical disability such as the inability to erect in males and the inability to enjoy sexual experiences in both males and females.

obesity dangers
Obesity can have detrimental effects on both males and females.

Implication of Obesity in General Health

Over time, excessive weight bearing can be associated with general physical limitation, chronic fatigue, and predisposition to arthritic symptoms such as joint aches and pain [9].

Obesity is also known to correlate with an increased risk of cardiovascular and metabolic disorders.  Obesity increases the chance of developing heart disease, hypertension, high cholesterol, type-2 diabetes, and even cancers [10].

Side effects of medications from chronic conditions, such as anti-hypertensives [11] and diabetes medications [12], can lead to sexual dysfunction and reduced libido, hence indirectly affecting a person’s sexual well-being.

Mental Health and Obesity

Clinical studies have shown the correlation between obesity and mental health disorders such as anxiety and depression [13]. These mood disorders can have a negative impact on a person’s sexual relationship with others. One can be disinterested in sexual activities, having poor libido and unable to enjoy their sexual life.

One might also have lower self-esteem and be embarrassed about their body image, hence having lower sexual confidence and dissatisfaction with their sexual life. 

depression and obesity
Obesity has been linked to mental health problems such as depression and anxiety.

What can I do if my BMI is elevated?

Weight management should be a holistic approach. Medical management of weight loss with prescription drugs should be followed by a targeted, realistic eating plan and consistent, achievable physical activities to achieve the target weight and maintain that ideal weight.

Healthy eating

Make clever decisions when choosing food options and quantity to ensure balanced nutrients are acquired yet not overeating.

  • Consider a healthy meal plate portion – ½ portion of fruits and vegetables, ¼ portion of grains and ¼ portion of protein.
  • Reduce intake of salt, sugar, and fatty food.
  • Rather than completely omitting your favourite food, reduce your intake and set realistic, rewarding targets to enjoy occasional cravings.
  • Opt for healthy snacks such as nuts rather than biscuits and crisps.

Physical activities

Regular physical activity helps lower weight and achieve a healthy weight. Staying motivated and consistent with your physical regimen is key to achieving and maintaining your target weight in the long run.

Being creative and engaging in physical activities are useful to stay motivated and consistent with your exercise.

  • As a starter, consider walking/brisk walking for 10-15 minutes, gradually building up the duration of the workout to 30-40 minutes.
  • Stretching exercises such as Qigong, Yoga, and Pilates are healthy.
  • Swimming, gym, and biking are other options if facilities are available.
  • Using stairs rather than lifts is another method.
  • Parking your vehicle further from the destination allows you to mobilise and walk more to and fro from a destination.
exercise and weight loss
Regular exercise and healthy eating can reduce the effects of obesity.

Role of Weight Loss Injections in Long-term Management of Obesity

Most people struggle with long-term weight loss. Many may have tried to lose weight, only to regain it as time passed. Medical treatment of weight management can address this concern effectively and safely.

Weight Loss Injections

  • A physician prescribes this FDA-approved weight loss medication to help patients lose and maintain a healthy weight. 
  • The medication is not a substitute for exercise and moderate eating; it is used as an adjunct to achieve the ideal weight. 
  • It is a type of GLP-1 receptor agonist that increases a person’s satiety by reducing a person’s appetite and slowing down stomach emptying. 
  • It has been clinically proven to reduce a person’s weight significantly. 

Under the guidance of your prescribing medical practitioner, these weight loss injections can be titrated safely and effectively to reduce a person’s weight. Clinical studies over three years in patients who are on the medication show that 56% of patients can lose significant weight at the 1-year mark of taking the medication [14].

What have I learnt today?

  • Obesity can affect a person’s sexual well-being.
  • This is another important reason for managing obesity holistically.
  • Weight loss and maintaining a healthy weight lowers the risk of cardiovascular comorbidities and promises better mental health and sexual well-being.
  • When considered together with exercise and moderate eating, medical management of weight can be delivered safely and effectively.

If you have concerns about your weight, you are encouraged to reach out to your trusted physician to learn more about the medical management of weight control.


  1. Ministry of Health Singapore. (2022). National Population Health Survery 2022. Singapore: Ministry of Health.
  2. David B. Sarwer, A. J. (2019). Obesity and Sexual Functioning. Current Obesity Reports, doi: 10.1007/s13679-018-0319-6.
  3. Renato Pasquali, C. O. (2019). 120 - 134: Obesity and Androgens in Women . In F. O. RESEARCH, Hyperandrogenism in Women (p. DOI: https://doi.org/10.1159/000494908).
  4. Luboslav STÁRKA, M. H. (2020). Estradiol, Obesity and Hypogonadism. Physiological Research, doi: 10.33549/physiolres.934510.
  5. Gireeja Walke, S. S. (2023). The Impact of Oxidative Stress on Male Reproductive Function: Exploring the Role of Antioxidant Supplementation. Cureus, doi: 10.7759/cureus.42583.
  6. Divya Gautam, N. P. (2023). The challenges of obesity for fertility: A FIGO literature review. Gynacology & Obstetrics, https://doi.org/10.1002/ijgo.14538.
  7. Massimo Volpe and Giovanna Gallo, t. w. (2023). Obesity and cardiovascular disease: An executive document on pathophysiological and clinical links promoted by the Italian Society of Cardiovascular Prevention (SIPREC). Frontiers in Cardiovascular Medicine, doi: 10.3389/fcvm.2023.1136340.
  8. Yashi, K., & Daley., S. F. (2023). Obesity and Type 2 Diabetes. Florida: Statpearls.
  9. Dryden, J. (23 October, 2019). Arthritis risk linked to obesity may be passed down through generations. Retrieved from Washington University School of Medicine in St. Louis: https://medicine.wustl.edu/news/arthritis-risk-linked-to-obesity-may-be-passed-down-to-children-grandchildren/
  10. Contributors, W. E. (4 January, 2023). Health Risks Linked to Obesity. Retrieved from WebMD: https://www.webmd.com/obesity/obesity-health-risks
  11. Inmaculada Xu Lou, J. C. (2023). Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. Dovepress, https://doi.org/10.2147/VHRM.S439334.
  12. Hayder M. Al-Kuraishy, A. I.-G. (2016). Erectile Dysfunction and Low Sex Drive in Men with Type 2 DM: The Potential Role of Diabetic Pharmacotherapy. Journal of Clinical and Diagnostic Research, DOI : 10.7860/JCDR/2016/19971.8996.
  13. Khalid A Al Nasser, Y. K. (2024). Correlation Between Obesity and Mental Health Status in Riyadh, Saudi Arabia. Cureus, doi: 10.7759/cureus.53976.
  14. Saxenda. (July, 2023). Weight Loss with Saxenda. Retrieved from Saxenda: https://www.saxenda.com/about-saxenda/weight-loss-with-saxenda.html#isi-anchor  

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Obesity is defined as having an excess amount of fat in your system.